A new report published this month looks at the experiences of women who've undergone cosmetic surgery. But does the report reflect reality? Jennifer Bradbury finds out

At 16 Lorraine Smith felt inadequate. Her problem, as she saw it, was her flat chest. She insists there was absolutely nothing there.

Friends and family assured her it would be a different story by the time she was 18. By then, they said, she'd be busting out all over.

But at 18 her breasts had still failed to bud.

Again, everyone said things would be better by the time she turned 21, and she put the disappointment behind her.

But three years later, as she celebrated this major milestone, when she looked down it still left her feeling miserable.

Her breasts had failed to emerge. Her measurements were a disappointing 32A and she couldn't even fill a bra without the help of air filled sacs.

"My mum told me not to worry. She'd always been flat-chested but by her early 40s she'd started to fill out. I was horrified. I couldn't wait that long," says Lorraine, 25, of Easington Colliery, County Durham.

The thought of waiting for boobs until her early 40s made Lorraine's decision to have cosmetic surgery to enlarge her breasts all the easier.

"You only live once," she argues, as she proudly struts her artificially-constructed breasts.

"They are beautiful," she says, like a new mother talking about her babies.

Sick of relying on padded bras and pads, Lorraine, a travel agent in Sunderland, took the plunge and underwent breast augmentation (enlargement) after approaching the Transform Clinic in Jesmond, Newcastle.

"I didn't want to be Pamela Anderson or Jordan," she giggles. "But clothes just didn't fit me properly. Clothes are made for women with breasts and that's where I was lacking."

Now, after surgery she boasts a bust that is 32C, and she couldn't be more delighted.

"I fill a bikini," she squeals. "I could never have gone topless before and now for the first time I've done it and it was great."

The operation cost her &#xA3;3,400 which she paid for by increasing an existing loan.

"When you think how much you spend on a car or a holiday and then take into account how long my boobs will last and the happiness they've brought, it's money well spent," she reasons.

"My parents told me I was beautiful as I was but if you're not happy with the way you are why stick with it? I think they thought I'd grow out of it, but they were very supportive when they realised I was serious."

She's not averse to talking about her boob job, she enjoys it, especially when people comment on how good her breasts look.

"It's not that people notice I've had a boob job, they look real. But when it comes up in conversation I tell anyone about them. You don't go from being flat to having a C cup boob overnight so people were going to find out anyway. But I tell people I don't know."

She met boyfriend Dave Wise six months before she had surgery and he liked the way she looked pre-op. But Lorraine says he prefers her now.

So did the operation meet her expectations? "Oh, and so much more. I'm over the moon. The only regret I have is that I didn't do it earlier."

A new NOP report commissioned by The Harley Medical Group, leading experts in cosmetic surgery, has looked at the emotional experiences of 100 patients before and after surgery.

According to the report the main motivation for surgery was the desire to improve appearance (32 per cent), with nearly a quarter of all patients not happy with the way they look, rising to half of rhinoplasty patients.

It also found that 70 per cent of patients paid for their surgery from savings. Breast surgery patients were most likely to take a loan to finance surgery, with 30 per cent citing this as opposed to 23 per cent of all.

The report also found that 23 per cent claimed their parents were shocked, rising to 35 per cent of breast patients, while 24 per cent said their parents admired them for undergoing surgery. A massive 79 per cent said that surgery had a positive effect on their confidence, rising to 90 per cent of breast patients.

Debra Bartram, 35, of Wallsend, had rhinoplasty, (nose surgery), earlier this year with Transform, and she's delighted with the results.

She used money she'd inherited to cover the &#xA3;2,900 cost.

"I hated everything about my nose. I had uneven nostrils and what you'd call a Roman nose with a ridge in it. I wore specs and I'd never take them off in public, I felt everyone was looking at my profile. I hated going on holiday."

Debra, an administrator in the motor industry, says she wanted a nose job since she was a teenager. "But I never had the money, and when I did there was always something else to spend it on. I wish I had done it earlier - you've only got one life."

"I'm over the moon with it," she says. "I get up in the morning and put my make-up on and I look at my nose in the mirror and keep touching it. It's great. It's beautiful."

Debra says she didn't undergo surgery with a pre-conceived idea of how her new nose would look.

"I didn't want a J-Lo or anything. I just wanted a nice nose and that's what I've got. They've taken out the ridge and made my nostrils even," she adds.

Any concerns Debra had were allayed during consultations when she was given detailed information on what could go wrong. "You hear horror stories about cosmetic surgery but rarely stories about people who've come away delighted. The way I looked at it was that even if the operation went wrong, the nose I ended up with couldn't be any worse than the one I had," she says.

She stayed in the private hospital overnight after her operation and the cast and stitches were removed a week later.

"Even though my nose was still slightly swollen and I had yellow bruising round my eyes I could tell immediately that it was an improvement."

Her partner, Alan Ormston, 42, underwent similar surgery for medical reasons before, and was extremely supportive of Debra's decision. "He never said anything about my nose before but I know he prefers it now," she says.

Since having the operation in January Debra's been on holiday and for the first time she enjoyed it.

"It was just so nice not to think that people were looking at my nose and my profile. It really has given me a new lease of life."

Fiona Corson, 27, of Shieldfield, Newcastle had a problem other women might envy, her breasts, she felt, were too big.

"Men would talk to my chest. Some people like that sort of attention but I didn't. It had started at school and it used to make me very self conscious. I always wore clothes that would cover them up."

The size of her breasts also placed restrictions on the type of clothes she wore. "I couldn't wear a strapless top, as it would just emphasise them."

She says her determination to get something done about her boobs was strengthened after she lost a lot of weight when she was about 17.

"It was at that point I realised these things were not going anywhere. I was totally out of proportion."

She admits the decision to have her breasts reduced wasn't medical. Although their size did cause her some discomfort it wasn't enough to go ahead with surgery. She just hated them.

Fiona, who works in child mental health, started to look into cosmetic surgery about a year before she had the operation and decided to go with the Harley Medical Group based in Jesmond, Newcastle.

"It's not something I went into lightly. I think you should know everything before you make the decision but I'm very happy with the outcome."

She didn't confide her decision to anyone, and told her family only after she'd gone through with the operation. She's also reluctant to talk about it with work colleagues, preferring to keep it quiet.

It cost her just over &#xA3;5,000 for the surgery which she financed through savings and with her credit card.

She stayed at the private hospital for two days after the operation and a week later bandages came off.

"I was pleased and horrified at the same time. Obviously it was a shock as you're used to your body looking one way and then it looks completely different. But I was pleased to see at that early stage that they were looking smaller."

Fiona went from a 32F to a 32D and says the operation has improved her confidence and given her a new lease of life. For the first time in her life she's had the confidence to go out in a strapless dress.

Richard Milner, a consultant plastic surgeon at Nuffield and RVI Hospitals in Newcastle with 18 years experience in cosmetic surgery, says the main effect of surgery on a patient is a boost in confidence.

"It improves the way they feel about themselves."

He adds: "It's up to people what they spend their money on and they can take a loan out for a holiday or a car and it's their decision if they decide to take one out for surgery. But I would advise people not to put themselves into financial difficulties."

* Harley Medical Group is on 0800 085 9085. Transform is on 0500 202020.

Why patients opt to go under the knife

Here are some of the major finds of the report commissioned by the Harley Medical Group by NOP Healthcare.

Report overview was provided by Dr Glenn Wilson, reader in personality at the Institute of Psychiatry, University of London, while the surgeon overview was provided by plastic surgeon, Patrick Whitfield, medical director of the Harley Medical Group.

Key motivating factors behind the decision to have surgery:

* A third (32 per cent) of all respondents indicated a desire to improve their appearance.

* Nearly a quarter (24 per cent) of all patients were not happy with the way they looked, rising to half of rhinoplasty patients.

* Although just 18 per cent of all underwent surgery to `boost their confidence', 29 per cent of breast patients cited this as their key motivating factor.

* 17 per cent underwent breast surgery due to the `body changing after childbirth', the only patients to cite this as a key factor for surgery.

* Only 3 per cent of all respondents stated that `pure vanity' was the key factor,

* 12 per cent of all patients cited the surgery as `something they always wanted to do', rising to a third of rhinoplasty patients. This group was also the only group to name `peer pressure, being teased or called names' (8 per cent) as the key reason for surgery.

Overview: "Only 24 per cent of patients have indicated they were not happy with the way they looked pre-surgery, therefore 76 per cent of patients were not necessarily unhappy with the way they looked.

"This reflects the mindset of current society which believes improvements should and can be sought in all aspects of our lives, be it in relationships, work or lifestyle environments, or physical appearances."

Surgeon's Comment: "The motivation for cosmetic surgery varies enormously from procedure to procedure, it stands to reason that the motivation for a breast patient is not necessarily going to be the same as that of a rhinoplasty patient. I'm surprised, however, that only 24 per cent of patients claimed to be unhappy about their appearance."

Patient's Comment: "I take my appearance quite seriously, I enjoy buying nice clothes, good jewellery and also have regular facials. Although I wasn't unhappy with my appearance, I knew I would look better for having a blepharoplasty as I did have noticeable bags under my eyes."

* 23 per cent of all claimed their parents were shocked at them having surgery rising to 35 per cent of breast patients, while 24 per cent of all said their parents admired them for undergoing the surgery.